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On September 18, 1998 Order Amending The Of 19 June 1997, Which Develops The Royal Decree 575/1997, 18 April, Amending Certain Aspects Of Management And Control Of The Economic Benefit Of The Soci Security...

Original Language Title: Orden de 18 de septiembre de 1998 por la que se modifica la de 19 junio de 1997, que desarrolla el Real Decreto 575/1997, de 18 de abril, que modifica determinados aspectos de la gestión y del control de la prestación económica de la Seguridad Soci...

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TEXT

Royal Decree 575/1997 of 18 April 1997 regulating certain aspects of the management and control of the economic performance of social security for temporary incapacity has been the subject of recent amendments to the through Royal Decree 1117/1998 of 5 June, issued under the development of Article 131.1a of the General Law on Social Security, in the wording of Article 39 of Law 66/1997 of 30 December 1997 on fiscal, administrative and of the social order.

These amendments make it necessary to update the Order of 19 June 1997, for which the said Royal Decree 575/1997 is developed.

In its virtue, prior to the report of the Minister of Health and Consumer and in accordance with the privileges granted by the Final Disposition First of Royal Decree 575/1997, of April 18, I have arranged:

Single item.

The articles of the Order of 19 June 1997, for which Royal Decree 575/1997 is developed, of 18 April 1997, amending certain aspects of the management and control of the economic performance of temporary incapacity, which are listed below, are worded as follows:

One.

" Article 4. High medical parts.

1. The medical part of the discharge in the situation of temporary incapacity shall be issued by the optional Public Health Service, after the worker's recognition, extending by four-fold, using the model that is accompanied as Annex I.

Also, the medical part of the discharge may also be extended by the physician attached to the National Social Security Institute. To this end, this optional, after recognition of the worker, must communicate, through the appropriate organ of the Provincial Directorate of the said managing body, and using the model of communication accompanying it as Annex V, to the Inspection of Health Services of the Social Security or equivalent organ of the corresponding Public Health Service, the intention to formalize the medical discharge, remitting them immediately copy of the corresponding part, extended in the terms and with the effects contained in paragraphs 3 and 4 of this Article, in order to ensure that (a) the said bodies may, within three working days of the communication of the intended intention, expressly express their reasoned disagreement. If the indicated disagreement is not received within the period referred to above, the medical part of the discharge shall have an effect on the terms set out in the above paragraphs.

The medical part of discharge issued by the National Institute of Social Security shall be extended, by an exemplary fourfold, using, for that purpose, the model accompanying it as Annex V. In cases where the If it has been issued on the initiative of a mutual, it shall be extended, using the model set out in the Annex, by an exemplary fivefold.

2. When the medical part of the discharge is issued by the health service provider, the following procedure will be followed:

First.-The original of the medical part of discharge, in which the result and the cause which motivates the discharge in the situation of temporary incapacity, will necessarily go to the Inspection of the Health Services of the Social security or equivalent organ of the respective Public Health Service.

Second. -From the high-issued medical part, delivery will be made to the two-copy worker, one for the person concerned and one for the company.

The copy of the medical part to the undertaking shall be submitted to it by the worker within twenty-four hours, and the copy shall be sent by the worker, after completion of the relevant paragraphs. the managing or mutual entity, as appropriate, within a period of five days from the day of its receipt.

When the employment relationship has been extinguished, the worker himself shall be required to present directly to the managing or mutual entity, as appropriate, the copy of the medical part of discharge, within the same time limit set for the company.

Third. In turn, issued the medical part of discharge by the respective Public Health Service, it shall be transmitted to the managing or mutual entity, as appropriate, the copy to it intended, within the period of five days from the date of departure of the party's expedition. Such a copy shall necessarily consist of the result and the cause of the discharge in the situation of temporary incapacity.

3. For the purposes referred to in the second subparagraph of paragraph 1, the dispatch of the medical discharge parts shall comply with the following:

First.-Once the worker has been recognized and when, in the opinion of the National Social Security Institute's physician, it is appropriate to issue the discharge, the extension of a part of the discharge, conditioned to the decision of the Health Services Inspectorate of the Social Security or equivalent body of the respective Health Service, in the terms referred to in paragraph 1, reflecting in that part, and as the date of the discharge, the fifth day The following is the business of that extension.

Second. -Exorder the medical part of discharge, in the terms mentioned in the previous paragraph, in the same act will be given to the worker of two copies, one for the interested and one for the company.

If the worker, within five working days following the issue of the medical part of discharge, has not received, from the National Social Security Institute, communication on the existence of disconformity The person concerned shall submit to the undertaking, and within 24 hours of the date of the discharge, the copy to the undertaking concerned.

Third. -After the end of the three working days following the communication of the intention to issue the discharge to the Health Services Inspectorate of the Social Security or equivalent organ of the respective Public Health Service, without the express disconformity expressed in relation to the high cited, will be transmitted to the corresponding Public Health Service the copy of the medical part of discharge to the destined, in which it must the result and the cause that motivates the discharge in the situation of incapacity temporary.

4. In cases where the medical part of the discharge, to be issued by the National Institute of Social Security, is preceded by the initiative of a Mutua of Occupational Accidents and Occupational Diseases of Social Security, in the The terms of Article 15 shall be as follows:

First.-Once the worker has been recognized and when, in the opinion of the National Social Security Institute's physician, it is appropriate to issue the discharge, the extension of a part of the discharge, conditioned to the decision of the Health Services Inspectorate of the Social Security or equivalent body of the respective Health Service, in the terms referred to in paragraph 1, reflecting in that part, and as the date of the discharge, the fifth day The following is the business of that extension.

Second. -Exorder the medical part of discharge, in the terms mentioned in the previous paragraph, will be given to the worker of two copies, one for the interested party and one for the company.

If the worker, within five working days following the issue of the medical discharge, has not received, on the part of the National Social Security Institute, communication on the express disconformity of the corresponding Public Health Service in respect of the high issued, must present to the company, and within twenty-four hours after the date of the effects of the medical discharge, the copy to that intended.

Third. -Similarly, and after the expiry of the period within which the Medical Inspectorate may express its disagreement, it shall, within five days of the following five days, be sent to the Mutua which made the initiative, along with the copy of the part destined for the Public Health Service, so that by this collaborating entity it will make it to the indicated Public Service. In both copies, the result and the cause of the discharge in the situation of temporary incapacity must necessarily be recorded.

If the express disconformity has been produced by the Health Services Inspectorate of the Social Security or equivalent Authority of the respective Health Service, the same will be transferred to the Mutua that raised the High-medical expedition initiative.

5. The discharge issued by the doctor attached to the National Social Security Institute, to the exclusive economic effects, shall determine the extinction of the economic benefit due to temporary incapacity, from the day of the medical discharge, and the the right of the worker to join the company, without prejudice to the continued provision of health care by the Public Health Service which, without requiring a new medical discharge, advises its state.

When the medical discharge issued by the National Institute of Social Security has been preceded by the corresponding initiative of the Mutua, to correspond to a process of temporary incapacity managed by the (a) the termination of the economic benefit of temporary incapacity shall be effected, on the basis of the discharge issued and effective from the day of the medical discharge, by act adopted by the relevant mutual, in accordance with Article 80 of the Rules of Procedure for the Cooperation of Mutual the management of Social Security. "

Two. Paragraphs 3 and 4 are added to Article 5.or in the following terms:

" 3. In cases where the medical part of the discharge is to be issued by the medical services of the National Social Security Institute, the following shall be performed:

First.-Once the worker has been recognized and when, in the opinion of the National Social Security Institute's physician, it is appropriate to issue the discharge, the extension of a part of the discharge, conditioned to the decision of the Health Services Inspectorate of the Social Security or equivalent body of the respective Health Service, in the terms referred to in Article 4 (1).or, reflecting on that part, and as a date of effect of the discharge, the fifth working day following that of that extension.

The economic benefit of temporary incapacity shall be extinguished from the day of the effects of the extended medical discharge, except in cases where the Health Services Inspectorate or the equivalent body of the respective Public Health Service expresses express disagreement within the period referred to in the second subparagraph of Article 4 (1).or If this is the case, the person concerned shall be notified immediately of such circumstances.

Second. -After the end of the three working days following the communication of the intention to issue the discharge to the Health Services Inspectorate of the Social Security or equivalent organ of the respective Public Health Service, without the express disconformity expressed in relation to the high cited, will be transmitted to the corresponding Public Health Service the copy of the medical part of discharge to the destined, in which it must the result and the cause that motivates the discharge in the situation of incapacity temporary.

4. In cases where the medical part of the discharge, to be issued by the National Institute of Social Security, is preceded by the initiative of a Mutua of Occupational Accidents and Occupational Diseases of Social Security, in the The terms of Article 15 shall be as follows:

First.-Once the worker has been recognized and when, in the opinion of the National Social Security Institute's physician, it is appropriate to issue the discharge, the extension of a part of the discharge, conditioned to the decision of the Health Services Inspectorate of the Social Security or equivalent body of the respective Health Service, in the terms referred to in Article 4 (1).or, reflecting on that part, and as a date of effect of the discharge, the fifth working day following that of that extension.

Second.-After the expiry of the period within which the Medical Inspectorate may express its disagreement, the rapporteur shall be sent to the Mutua, and within five days of the following five days, the copy of the medical part of discharge to her intended, together with the copy of the one destined for the Public Health Service, so that the collaborating entity refers it to the aforementioned Public Service. Such copies shall necessarily include the result and the cause of the discharge in the situation of temporary incapacity.

If the express disconformity has been produced by the Health Services Inspectorate of the Social Security or equivalent Authority of the respective Health Service, the same will be transferred to the Mutua that raised the High-medical expedition initiative.

Third. The extinction of the economic benefit of temporary incapacity shall be carried out, on the basis of the discharge and effectiveness of the day of effects of the medical discharge, by act adopted by the corresponding mutual, in accordance with Article 80 of the Rules of Procedure for the Cooperation of Mutual Societies in the Management of Social Security. "

Three. Article 8.or is worded as follows:

" 1. The medical part of the discharge in the situation of temporary incapacity shall be issued by the optional Public Health Service, after the worker has been recognized, extending by quadrupling, using the model accompanying the model as Annex III.

Also, the medical part of the discharge may also be extended by the physician attached to the National Social Security Institute. To this end, this optional, after the worker's recognition, must communicate, through the appropriate organ of the Provincial Directorate of the said managing body and using the communication model accompanying the communication model in Annex VI, to the Inspection of Health Services of the Social Security or equivalent organ of the corresponding Public Health Service, the intention to formalize the medical discharge, remitting them immediately copy of the corresponding part, extended in the terms and with the effects contained in paragraph 3 of this Article, in order to ensure that (a) the said bodies may, within three working days of the communication of the intended intention, expressly express their reasoned disagreement. If the indicated disagreement is not received within the prescribed period, the medical part of the discharge shall have an effect on the terms set out in that paragraph.

The medical part of discharge issued by the National Institute of Social Security shall be extended, by an exemplary fourfold, using, for that purpose, the model accompanying it as Annex VI.

2. When the medical part of the discharge is issued by the health service provider, the following procedure will be followed:

First.-The original of the medical part of discharge, in which the result and the cause which motivates the discharge in the situation of temporary incapacity, will necessarily go to the Inspection of the Health Services of the Social security or equivalent organ of the respective Public Health Service.

Second. -Exorder the medical part of discharge, will be given to the worker of two copies, one for the interested party and one for the company. The copy of the medical part to the undertaking shall be submitted to the undertaking by the worker within 24 hours, and the copy shall be forwarded to the managing body, after completion of the relevant paragraphs. within a period of five days from the day of their receipt.

When the employment relationship has been extinguished, the worker himself is obliged to present the copy of the medical part of discharge directly to the managing body, within the same time limit set for the company.

Third. In turn, issued the medical part of discharge by the respective Public Health Service, the managing body shall be sent the copy to it intended, within the period of five days from the issue of the party. Such a copy shall necessarily consist of the result and the cause of the discharge in the situation of temporary incapacity.

3. In the cases referred to in the second subparagraph of paragraph 1, the dispatch of the medical discharge parts shall comply with the following:

First.-Once the worker has been recognized and when, in the opinion of the National Social Security Institute's physician, it is appropriate to issue the discharge, the extension of a part of the discharge, conditioned to the decision of the Health Services Inspectorate of the Social Security or equivalent body of the respective Health Service, in the terms referred to in paragraph 1, reflecting in that part, and as the date of the discharge, the fifth day The following is the business of that extension.

Second. -Exorder the medical part of discharge, in the terms mentioned in the previous paragraph, in the same act will be given to the worker of two copies, one for the interested and one for the company.

If the worker, within five working days following the issue of the medical part of discharge, has not received, from the National Social Security Institute, communication on the existence of disconformity The person concerned shall submit to the undertaking, and within 24 hours of the date of the discharge, the copy to the undertaking concerned.

Third. -After the expiry of the three working days following notification of the intention to issue the discharge to the Health Services Inspectorate of the Social Security or equivalent organ of the respective Public Health Service, without the express disconformity expressed in relation to the high quoted, will be transmitted to the respective Public Health Service the copy of the part of the discharge to the destined, in which it must be stated, necessarily, the result and cause that motivates the high in the temporary disability situation.

4. The discharge issued by the doctor attached to the National Social Security Institute, to the exclusive economic effects, shall determine the extinction of the economic benefit due to temporary incapacity from the day of the medical discharge, and the the worker's right to return to the company, without prejudice to the continued provision of health care by the Public Health Service, which, without requiring a new medical discharge, advises his or her state. "

Four. A new paragraph is added to Article 9.or in the following terms:

" In cases where the medical part of the discharge is to be issued by the optional National Social Security Institute, it will be performed as follows:

First.-Once the worker has been recognized and when, in the opinion of the National Social Security Institute's physician, it is appropriate to issue the discharge, the extension of a part of the discharge, conditioned to the decision of the Health Services Inspectorate of the Social Security or equivalent body of the respective Health Service, in the terms referred to in Article 8 (1).or, reflecting on that part, and as a date of effect of the discharge, the fifth working day following that of that extension.

The economic benefit of temporary incapacity shall be extinguished from the day of the effects of the extended medical discharge, except in cases where the Health Services Inspectorate or the equivalent body of the respective Public Health Service expresses express disagreement within the period referred to in the second subparagraph of Article 8 (1).or If this is the case, the person concerned shall be notified immediately of such circumstances.

Second. -After the expiry of the three working days following the date of the communication of the intention to issue the medical discharge to the Health Services Inspectorate of the Social Security or equivalent organ of the Public Health Service, without any express disagreement regarding the medical discharge, will be sent to the corresponding Public Health Service the copy of the part of the discharge to the destined, in which it must the result and the cause that motivates the discharge in the situation of incapacity temporary. "

Five. A new Article 15 is added, with the following wording:

" Article 15. Medical services of the National Institute of Social Security, on the initiative of the medical services of the mutual.

1. When the proposal of a High formulated by the Mutua is not resolved within the deadlines mentioned in the previous article, the contributing entity may choose to reiterate that proposal, in the terms mentioned in the previous article, or to raise the health care initiative before the medical services of the National Social Security Institute, for the purposes provided for in Article 1 (4).or of Royal Decree 575/1997. In the event that the initial proposal to the Public Health Service, the Mutua does not obtain a new answer from that Service, will be able to propose the initiative to the medical services of the National Security Institute. Social.

2. The approach of the High Medical Initiative to the medical services assigned to the Provincial Directorates of the National Institute of Social Security shall be accompanied, in accordance with the provisions of this Article, by the following documents:

(a) Personal data identifying the worker, number of National Identity Document and Social Security affiliation, as well as those relating to the address of the worker, for the purposes of the corresponding notifications.

b) Copy of the initial low medical part.

c) Where appropriate, and depending on the duration of the temporary disability process, copy of the medical parts of confirmation of the discharge in which the supplementary medical reports are contained (Article 1.or, 3 of the Royal Decree 575/1997), as well as the control report issued by the Medical Inspection of Social Security or equivalent organ of the respective Public Health Service (Article 1.or 5 of Royal Decree 575/1997).

d) The result of medical examinations that would have been carried out on those interested in the medical services of the Mutua, in the terms laid down in Article 6.or of Royal Decree 575/1997.

e) Job position and description of the tasks performed by the worker, as well as other labour data of the person concerned, to enable an objective assessment of the incidence of the diseases suffered by the worker to go to work or resume professional activity on the part of the job.

f) A copy of the supporting documentation of having previously formalized the proposal of discharge to the respective Public Health Service, as well as, if necessary, reiteration of the same, in order to justify that it has not been obtained reply to the respective Public Health Service, in the terms and time limits set out in the previous article.

g) Report on the causes which, in the mutual opinion, justify the approach of the medical discharge.

3. If the medical discharge initiative is presented without the documents and data referred to in paragraph 2 being provided, the Mutual Fund shall be required to provide the information within ten days or, where appropriate, to indicate the causes of the initiative. presentation of those, with the indication that, if they do not do so, they will be given a withdrawal in their request, in accordance with the provisions of Article 71 of Law 30/1992 of 26 November 1992, of the Legal Regime of the Administrations Public and the Common Administrative Procedure. "

Six. Annexes I to IV are amended and new Annexes V and VI are incorporated, with the following wording:

" ATTACHMENTS

Annex I. Low/high temporary disability medical parts, by common contingencies.

Annex II. Medical parts for temporary disability confirmation, for common contingencies.

Annex III. Low/high medical parts of temporary disability due to professional contingencies.

Annex IV. Medical parts for confirmation of temporary incapacity for professional contingencies.

Annex V. Communication of the intention of the National Institute for Social Security to issue the medical part of discharge of temporary incapacity for common contingencies and medical parts of discharge for temporary incapacity for common contingencies (to be issued by the doctors attached to the National Social Security Institute).

Annex VI. Notice of the intention of the National Institute of Social Security to issue the medical part of temporary incapacity for professional contingencies and medical parts of high temporary incapacity for contingencies professionals (to be issued by the doctors attached to the National Social Security Institute). "

Single additional disposition. The issue of medical leave of absence, when a medical discharge from the medical services of the National Institute of Social Security has been issued.

In accordance with the provisions of the first provision of Royal Decree 1117/1998 of 5 June 1998, when the medical part of the discharge for the medical services assigned to it has been issued in a temporary incapacity process the National Social Security Institute, for the six months following the date on which the National Social Security Institute was issued, the corresponding lower medical parts may only be issued by the Health Services Inspectorate Social or equivalent organ of the corresponding Health Service, in relation to the process pathological which originated the discharge, either on its own initiative or on a proposal from the Health Service practitioner.

Single transient arrangement. Use of medical parts models.

1. Until such time as they are made available to the respective Public Health Services or are edited by the Working Accident Mutuals, the corresponding lower/high medical parts, adapted to the models listed as Annexes I to IV, The two parties, including the Order of 19 June 1997, in the wording provided for in paragraph 6 of the Single Article, shall continue to use the parts which are published in the form of the models in force prior to the entry into force of this Regulation. Order.

2. As long as the medical discharge to be issued to the doctors of the National Institute of Social Security, adjusted to the models listed in Annexes V and VI of the Order of 19 June 1997, has not been published in the given wording. Paragraph 6 of the Single Article shall apply to the parties whose model is set out in Annexes I or III to the Order of 19 June 1997 respectively, taking into account, in turn, the provisions of paragraph 1 of this provision. In any event, it shall be stated, in a feisty manner, that the doctor who extends the medical part of the discharge does so in his condition as an optional member of the National Social Security Institute.

Final disposition. Entry into force.

This Order shall enter into force on the day following that of its publication in the "Official State Gazette".

Madrid, 18 September 1998.

BOCANEGRA SANDS

Excmo. Mr. Secretary of State for Social Security.

ANNEX I

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ANNEX II

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ANNEX III

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ANNEX IV

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ANNEX V

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ANNEX VI

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